检索结果-南通市图书馆

Management of hypoxemia in SARS-CoV-2 infection:Lessons learned from one year of experience,with a special focus on silent hypoxemia

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Intensive Medicine 2021年第1期1卷 26-30页

作者： Ricardo Serrano Xavier Corbella jordi rello Critical Care Department.Hospital de Hellín.Gerencia Atención Integrada de Hellín Albacete 02400Spain Interna Medicine Department Hospital Universitari de Bellvitge-IDIBELLL’Hospitalet de LlobregatBarcelona 08907Spain School of Medicine Universitat Internacional de CatalunyaBarcelona 08017Spain Vall d’Hebron Institute of Research Barcelona 08035Spain Research in Critical Care CHU CaremeauNîmes 30900France Centro de Investigación Biomédica en Red de Enfermedades Respiratorias(CIBERES) Instituto de Salud Carlos IIIMadrid 28029Spain

Silent hypoxemia is common in patients with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)*** this article,the possible pathophysiological mechanisms underlying respiratory symptoms have been reviewed,and the presence of hypoxemia without hypoxia is also *** experience we have gained since the start of the Coronavirus disease 19(COVID-19)pandemic has changed our point of view about which patients with respiratory involvement should be admitted to the intensive care unit/high-dependency unit for mechan-ical ventilation and *** patients with clinically well-tolerated mild to moderate hypoxemia(silent hypoxemia),regardless of the extent of pulmonary opacities found in radiological studies,the administration of supplemental oxygen therapy may increase the risk of endothelial *** risk of sudden respiratory arrest during emergency intubation,which could expose healthcare workers to infection,should be considered along with the risks of premature *** for intubation need to be revisited based on updated evidence showing that many patients with severe hypoxemia do not show increased work of *** has implica-tions in patient management and may explain in part reports of broad differences in outcomes among intubated patients.

关键词： COVID-19 Acute respiratory distress syndrome(ARDS) Pandemic Critical care

Ventilator-associated events: From surveillance to optimizing management

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Intensive Medicine 2023年第3期3卷 204-211页

作者： Sergio Ramirez-Estrada Yolanda Peña-Lopez Tarsila Vieceli jordi rello Intensive Care Department Hospital Sanitas CIMABarcelona 08034Spain Paediatric Critical Care Department Hospital Universitari Vall d’HebronBarcelona 08035Spain Clinical Research/Epidemiology in Pneumonia and Sepsis(CRIPS) Vall d’Hebron Research InstituteBarcelona 08035Spain Infectious Diseases Department Hospital de Clínicas de Porto AlegrePorto Alegre RS 90035-007Brazil Universitat Internacional de Catalunya Barcelona 08195Spain

Mechanical ventilation(MV)is a life-support therapy that may predispose to morbid and lethal complications,with ventilator-associated pneumonia(VAP)being the most *** 2013,the Center for Disease Control(CDC)defined criteria for ventilator-associated events(VAE).Ten years later,a growing number of studies assessing or validating its clinical applicability and the potential benefits of its inclusion have been *** with VAE criteria is retrospective and the focus is often on a subset of patients with higher thanlower *** date,it is estimated that around 30%of ventilated patients in the intensive care unit(ICU)develop *** surveillance enhances the detection of infectious and non-infectious MV-related complicationsthat are severe enough to impact the patient’s outcomes,there are still many gaps in its classification and *** this review,we provide an update by discussing VAE etiologies,epidemiology,and *** strategies on optimizing ventilation,sedative and neuromuscular blockade therapy,and restrictivefluid management are *** ideal VAE bundle is likely to minimize the period of *** believethat it is time to progress from just surveillance to clinical ***,with this review,we have aimed toprovide a roadmap for future research on the subject.

关键词： Intensive care Mechanical ventilation Infection control Ventilator-associated pneumonia

COVID-19-Associated Pulmonary Aspergillosis (CAPA)

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Intensive Medicine 2021年第2期1卷 71-80页

作者： George Dimopoulos Maria-Panagiota Almyroudi Pavlos Myrianthefs jordi rello Department of Critical Care University Hospital ATTIKONNational and Kapodistrian University of AthensAthens 12462Greece Department of Emergency Medicine University Hospital ATTIKONNational and Kapodistrian University of AthensAthens 12462Greece Department of Critical Care Agioi Anargyroi HospitalNational and Kapodistrian University of AthensAthens 14564Greece Universitat Internacional de Catalunya Barcelona 08035Spain

Invasive Pulmonary Aspergillosis(IPA)has been recognized as a possible secondary infection complicating Coronavirus disease 2019(COVID-19)and increasing *** aim of this review was to report and summarize the available data in the literature concerning the incidence,pathophysiology,diagnosis,and treatment of COVID-19-Associated Pulmonary Aspergillosis(CAPA).Currently,the incidence of CAPA is unclear due to different definitions and diagnostic criteria used among the *** was estimated that approximately 8.6%(206/2383)of mechanically ventilated patients were diagnosed with either proven,probable,or putative *** host factors of invasive aspergillosis are rarely recognized in patients with CAPA,who are mainly immuno-competent presenting with comorbidities,while the role of steroids warrants further *** epithelial injury and diffuse pulmonary micro thrombi in combination with immune dysregulation,hyper inflammatory response,and immunosuppressive treatment may be *** between two forms of CAPA(e.g.,tracheobronchial and parenchymal)is required,whereas radiological signs of aspergillosis are not typically evident in patients with severe COVID-19 *** previous studies,the European Organization for Research and Treatment of Cancer/Mycoses Study Group(EORTC/MSG)criteria,a clinical algorithm to diagnose Invasive Pul-monary Aspergillosis in intensive care unit patients(AspICU algorithm),and influenza-associated pulmonary aspergillosis(IAPA)criteria were used for the diagnosis of proven/probable and putative CAPA,as well as the differentiation from colonization,which can be *** fumigatus is the most commonly isolated pathogen in respiratory *** lavage(BAL)and serum galactomannan(GM),𝛽-d-glucan(with limited specificity),polymerase chain reaction(PCR),and Aspergillus-specific lateral-flow device test can be included in the diagnostic work-up;however,these approaches ar

关键词： COVID-19 Aspergillosis Diagnosis Treatment Intensive care unit Severe acute respiratory syndrome Coronavirus 2(SARS-CoV-2) Voriconazole

Female representation in intensive care medicine:Challenges and perspectives from China

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Intensive Medicine 2022年第2期2卷 89-91页

作者： Xuelian Liao Yi Yang Rubulotta Francesca Yan Kang jordi rello Department of Critical Care Medicine West China HospitalSichuan University.ChengduSichuan 610044China Department of Critical Care Medicine West China Tianfu HospitalSichuan University.ChengduSichuan 610213China Department of Critical Care Medicine Zhongda HospitalSchool of MedicineSoutheast UniversityNanjingJiangsu 210009China Department of Intensive Care Medicine McGill UniversityMontreal H3A 0G4Canada Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias Instituto de Salud Carlos IIIand Infections AreaVall d’Hebron Institute of ResearchBarcelona 08035Spain

The gender gap in the practice of intensive care medicine has increasingly been recognized as a problem in recent *** limited information,the available data suggest that representation of women in the physician workforce,academic positions,and leadership roles in intensive care is inadequate *** this article,we describe the situation of female intensive care unit(ICU)physicians from the perspective of Chinese *** proportion of female ICU physicians in China has been increasing in recent *** biggest challenges faced by female ICU physicians include balance of work and life,difficulties in career planning,and lack of academic *** attention and policy support should be provided to help them play a better role in intensive care medicine.

关键词： Gender gap Female Critical care

The future of training in intensive care medicine: A European perspective

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Intensive Medicine 2023年第1期3卷 52-61页

作者： Demosthenes Makris Vasiliki Tsolaki Ross Robertson George Dimopoulos jordi rello Medical School University of ThessalyLarisa 41110Greece Third Department of Critical Care Medical SchoolNational and Kapodistrian University of AthensAthens 12462Greece CRIPS Department Vall d'Hebron Institut of ResearchBarcelona 08035Spain Clinical Research CHU NîmesNîmes 30029France Medical School Universitat Internacional de CatalunyaCampus Sant CugatSant Cugat del VallesBarcelona 08195Spain

Introduction Intensive care medicine(ICM)is the science and art of preventing,caring for,and curing acutely ill *** specialty originated from the need to provide technology-centered organ support to the most fragile patients presenting with sequential and progressive organ failure.[1]Despite its genesis in Europe and extensive clinical and research achievements in the field,ICM has not been recognized as a distinct discipline in the European Union(EU).This has a negative impact on the free movement of intensivists across *** fact,it has been a major obstacle for knowledge and competence sharing,communication,and professional interweaving across borders—all of which are crucial requirements,especially when contending with pandemics and disasters.

关键词： acute originated spite

Prevention of ventilator-associated pneumonia through care bundles:A systematic review and meta-analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Intensive Medicine 2023年第4期3卷 352-364页

作者： Raquel Martinez-Reviejo Sofia Tejada Miia Jansson Alfonsina Ruiz-Spinelli Sergio Ramirez-Estrada Duygu Ege Tarsila Vieceli Bert Maertens Stijn Blot jordi rello Centro de Investigación Biomédica en Red de Enfermedades Respiratorias(CIBERES) Instituto de Salud Carlos IIIMadrid 28029Spain Clinical Research Epidemiology in Pneumonia&Sepsis(CRIPS) Vall d'Hebron Institute of Research(VHIR)Barcelona 08035Spain Research Unit of Health Sciences and Technology University of OuluOulu90570Finland RMIT University Melbourne3010Australia Critical Care Department Hospital de Clínicas Dr.Manuel QuintelaMontevideo11600Uruguay Critical Care Department Clínica CorachanBarcelona08017Spain Emergency Medicine Department Adnan Menderes UniversityAydin09010Turkey Infectious Diseases Department Hospital de Clínicas de Porto AlegrePorto Alegre90035-903Brazil Department of Internal Medicine and Pediatrics Ghent UniversityGhent9000Belgium FOREVA Clinical Research CHU NimesUniversitéde Nîmes-MontpellierNîmes30012France Medicine Department Universitat Internacional de Catalunya(UIC)Barcelona08017Spain

Background Ventilator-associated pneumonia(VAP)represents a common hospital-acquired infection among mechanically ventilated *** summarized evidence concerning ventilator care bundles to prevent *** A systematic review and meta-analysis were *** controlled trials and controlled observational studies of adults undergoing mechanical ventilation(MV)for at least 48 h were considered for *** of interest were the number of VAP episodes,duration of MV,hospital and intensive care unit(ICU)length of stay,and mortality.A systematic search was conducted in the MEDLINE,the Cochrane Library,and the Web of Science between 1985 and *** are reported as odds ratio(OR)or mean difference(MD)with 95%confidence intervals(CI).The PROSPERO registration number is *** Thirty-six studies including 116,873 MV participants met the inclusion criteria.A total of 84,031 participants underwent care bundles for VAP *** most reported component of the ventilator bundle was head-of-bed elevation(n=83,146),followed by oral care(n=80,787).A reduction in the number of VAP episodes was observed among those receiving ventilator care bundles,compared with the non-care bundle group(OR=0.42,95%CI:0.33,0.54).Additionally,the implementation of care bundles decreased the duration of MV(MD=−0.59,95%CI:−1.03,−0.15)and hospital length of stay(MD=−1.24,95%CI:−2.30,−0.18)in studies where educational activities were part of the *** regarding mortality were *** The implementation of ventilator care bundles reduced the number of VAP episodes and the duration of MV in adult *** application in combination with educational activities seemed to improve clinical outcomes.

关键词： Hospital-acquired pneumonia Ventilator bundle Prevention Quality improvement intervention

Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Intensive Medicine 2024年第1期4卷 81-93页

作者： Marie Dejonckheere Massimo Antonelli Kostoula Arvaniti Koen Blot Ben CreaghBrown Dylan Wde Lange Jan De Waele Mieke Deschepper Yalim Dikmen George Dimopoulos Christian Eckmann Guy Francois Massimo Girardis Despoina Koulenti Sonia Labeau Jeffrey Lipman Fernando Lipovestky Emilio Maseda Philippe Montravers Adam Mikstacki JoseArtur Paiva Cecilia Pereyra jordi rello JeanFrancois Timsit Dirk Vogelaers Stijn Blot the Abdominal Sepsis Study(AbSeS)group on behalf of the Trials Group of the European Society of Intensive Care Medicine Department of Internal Medicine and Pediatrics Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium Department of Anesthesiology Intensive Care and Emergency MedicineFondazione Policlinico Universitario A.Gemelli IRCCSRomeItaly UniversitàCattolica del Sacro Cuore RomeItaly Intensive Care Unit Papageorgiou University Affiliated HospitalThessaloníkiGreece Department of Epidemiology and Public Health SciensanoIxellesBelgium Surrey Perioperative Anaesthetic Critical Care Collaborative Research Group(SPACeR) Royal Surrey County HospitalGuildfordUK Department of Clinical and Experimental Medicine University of SurreyGuildfordUK Department of Intensive Care Medicine University Medical Center UtrechtUniversity UtrechtUtrechtthe Netherlands Department of Intensive Care Medicine Ghent University HospitalGhentBelgium Data Science Institute Ghent University HospitalGhentBelgium Department of Anesthesiology and Reanimation Cerrahpasa School of MedicineIstanbul University-CerrahpasaIstanbulTurkey rd Department of Critical Care “EVGENIDIO”HospitalNational and Kapodistrian University of AthensAthensGreece Department of General Visceral and Thoracic SurgeryKlinikum Hannoversch-MuendenGoettingen UniversityGöttingenGermany Division of Scientific Affairs-Research European Society of Intensive Care MedicineBrusselsBelgium Anesthesia and Intensive Care Department University Hospital of ModenaModenaItaly UQ Centre for Clinical Research Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia nd Critical Care Department Attikon University HospitalAthensGreece Department of Nursing Faculty of EducationHealth and Social WorkUniversity College GhentGhentBelgium Jamieson Trauma Institute The University of QueenslandBrisbaneQLDAustralia Nimes University Hospital University of MontpellierNimesFrance Critical Care Department Hospital of the Interamerican Open University(UAI)Buenos AiresArgentina Surgical Critical Care Department of AnesthesiaHospital Universitario

Background:The AbSeS-classification defines specific phenotypes of patients with intra-abdominal infection based on the(1)setting of infection onset(community-acquired,early onset,or late-onset hospital-acquired),(2)presence or absence of either localized or diffuse peritonitis,and(3)severity of disease expression(infection,sepsis,or septic shock).This classification system demonstrated reliable risk stratification in intensive care unit(ICU)patients with intra-abdominal *** study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the AbSeS-classification and ***:This was a secondary analysis of an international observational study(“AbSeS”)investigating ICU patients with intra-abdominal *** patients with pancreatic infection were included in this analysis(n=165).Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the *** with mortality were assessed using logistic regression analysis and reported as odds ratio(OR)and 95%confidence interval(CI).Results:The overall mortality was 35.2%(n=58).The independent risk factors for mortality included older age(OR=1.03,95%CI:1.0 to 1.1 P=0.023),localized peritonitis(OR=4.4,95%CI:1.4 to 13.9 P=0.011),and persistent signs of inflammation at day 7(OR=9.5,95%CI:3.8 to 23.9,P<0.001)or after the implementation of additional source control interventions within the first week(OR=4.0,95%CI:1.3 to 12.2,P=0.013).Gramnegative bacteria were most frequently isolated(n=58,49.2%)without clinically relevant differences in microbial etiology between survivors and ***:In pancreatic infection,a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term *** this limited series,essentials of the AbSeS-classification,such as the setting of infection onset,diffuse

关键词： Pancreatic infection Intensive care unit Mortality Intra-abdominal infection Sepsis

AME证据系列001--转化医学协会:脓毒症诊断和早期识别的临床实践指南

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

临床与病理杂志 2016年第10期36卷 1467-1476页

作者： Zhongheng Zhang Nathan J.Smischney Haibo Zhang Sven Van Poucke Panagiotis Tsirigotis jordi rello Patrick M.Honore Win Sen Kuan Juliet June Ray Jiancang Zhou You Shang Yuetian Yu Christian Jung Chiara Robba Fabio Silvio Taccone Pietro Caironi David Grimaldi Stefan Hofer George Dimopoulos Marc Leone Sang-Bum Hong Mabrouk Bahloul Laurent Argaud Won Young Kim Herbert D.Spapen Jose Rodolfo Rocco 张建成(译) 尚游(译) 钟鸣(校) Department of Emergency Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016 Department of Critical Care Medicine Jinhua Hospital of Zhejiang UniversityJinhua Zhejiang 321000 Department of Anesthesiology Mayo ClinicRochesterMNUSA Keenan Research Center for Biomedical Science of St.Michael's Hospital Departments of Anesthesia and PhysiologyInterdepartmental Division of Critical Care MedicineUniversity of TorontoTorontoONCanada Departments of Anesthesiology Critical CareEmergency Medicine and Pain TherapyZiekenhuis Oost-Limburgy GenkBelgium 2nd Department of Internal Medicine Attikcon University HospitalMedical SchoolNational and Kapodistrian University of AthensAthensGreece CIBERES Vall d'Hebron Institut of ResearchUniversitat Autonoma de BarcelonaSpain Universitair Ziekenhuis Brussely Vrije Universiteit Brussel Brussels BrusselsBelgium Emergency Medicine Department National University HospitalNational University Health SystemSingapore and the Department of SurgeryYong Loo Lin School of MedicineNational University of SingaporeSingapore DeWitt Daughtry Family Department of Surgery Jackson Memorial HospitalUniversity of Miami Leonard M.Miller School of MedicineMiamiFLUSA Department of Critical Care Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016 Department of Critical Care Medicine Union HospitalTongji Medical CollegueHuazhong University of Science and TechnologyWuhan 430022 Department of Critical Care Medicine Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200001 University Hospital Dusseldorf Heinrich-Heine-University DusseldorfMedical FacultyDivision of CardiologyPulmonology and Vascular MedicineDusseldorfGermany Neurosciences Critical Care Unit Addenbrooke's HospitalCambridgeUK Department of Intensive Care Hopital ErasmeUniversite Libre de Bruxelles(ULB)BrusselsBelgium Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti Fondazione IRCCS Ca'Granda-Ospedale

脓毒症是一种由感染引起的异质性疾病,感染触发了一系列复杂的局部或者全身的免疫炎症反应,引起多器官功能衰竭,发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准,所以脓毒症的临床诊断仍是一个难题。因此,脓毒症的临床诊... 详细信息

脓毒症是一种由感染引起的异质性疾病,感染触发了一系列复杂的局部或者全身的免疫炎症反应,引起多器官功能衰竭,发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准,所以脓毒症的临床诊断仍是一个难题。因此,脓毒症的临床诊断需要不断改变来满足临床和研究的要求。然而,尽管有许多新型的生物标记和筛选工具去预测脓毒症发生的风险,但是这些措施的诊断价值和有效性不足以让人满意,并且没有充分的证据去建议临床使用这些新技术。因此,脓毒症的临床诊断标准需要定期更新去适应不断产生的新证据。这篇综述旨在呈现当前脓毒症的诊断和早期识别方面的最新研究证据。临床运用不同的诊断方法的推荐意见依赖于推荐、评价、发展和评估分级体系(Grades of Recommendation Assessment,Development and Evaluation,GRADE),因为大部分的研究是观察性研究,并没有对这些方法进行可靠评估,采用的是两步推理方法。未来需要更多研究来确认或者反驳某一特殊的指标检测,同时应该直接采用相关病人的结果数据。

关键词：脓毒症早期识别诊断